Primary prevention
Primary prevention is avoidance of provocative motion environments by those with motion sickness disorder or visually induced motion sickness disorder (VIMSD), or at least the choice of less provocative modes of transport when feasible. However, when travel cannot be avoided, some protection from developing motion sickness may be afforded by several tactics.
In cars the driver should drive slowly and smoothly. The person susceptible to motion sickness should be in the front seat, be well restrained in the vehicle, not make head movements, and fix eyes on the horizon. Activities in the car such as reading should be avoided, as they create a conflict between vestibular reflexes working to stabilize the eyes on the external environment and visual reflexes tracking the text. Such sensory conflicts provoke and enhance motion sickness.
On ships and in trains, most benefit is obtained from sitting toward the front for a train and approximately in the middle for a ship.[12] A position near the center of rotations in a ship/boat minimizes the vertical, linear components of motion.
A view of the road ahead or of the horizon may help to prevent motion sickness in some individuals, whereas others fare better with eyes closed. For ship travel a position below deck lends greater susceptibility to becoming seasick in some people, whereas others may find greater relief from lying down, eyes closed. The individual traveler should determine the best tactic (eyes open or eyes closed; view the interior or the forward horizon).[12][22][59]
In high-speed tilting trains, motion sickness can largely be avoided by obscuring the view out of the window to the tilting landscape.[27]
In airplanes, motion sickness becomes significant during turbulence or landing and takeoff. The view out of the cabin window showing that the plane is tilting significantly and any head movements made during the maneuvering that provoke unusual vestibular stimulation can be highly nauseogenic. A susceptible passenger should sit still and close their eyes.
During turbulence the unpleasant visceral sensation provoked by the plane suddenly losing height can be minimized by tightening the seatbelt across the hips, bracing the body against a seat with the arms and legs, contracting ventral muscles of the torso, and focusing on controlling breathing so that it is regular and kept at moderate depth. Pressing the P6 acupuncture site (found between the tendons of the palmaris longus and flexor carpi radialis muscles, 3 patient finger breadths away from the flexor crease on the wrist) may help some patients.[60][61]
Focusing on controlling breathing at a regular rate of moderate depth will help prevent the development of motion sickness and alleviate symptoms. Respiratory cycles naturally entrain with periodic motion, such as on a ship. Deliberately desynchronizing breathing with the vehicle motion will provide greatest benefit.[62]
Being in control of the vehicle (e.g., driver, pilot, helmsman) rather than a passenger gives significant protection against motion sickness. Patients should be in control of the vehicle, if at all possible. In addition, passengers with a view of the road are less likely to have symptoms compared with those who do not.[13]
Other behavioral techniques to prevent or reduce motion sickness include staying hydrated; limiting alcohol and caffeine intake; eating small, frequent meals; avoiding smoking; and using distractions (e.g., controlled breathing, music, aromatherapy, flavored lozenges).[9]
Secondary prevention
Pharmacotherapy can be used for prevention of occasional motion sickness in those with motion sickness disorder or VIMSD. The drugs used include antimuscarinics (e.g., scopolamine) and H1 antihistamines (e.g., dimenhydrinate, meclizine).[70] Of these, scopolamine appears the most effective.[71]
[ 
]
Oral and transdermal preparations must be taken several hours before travel to achieve effective blood levels.
Use of this content is subject to our disclaimer